Ashley Lynn Mackie, RADT

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

1692 El Camino Real
San Carlos, CA 94070-5208

Phone

(650) 817-9070

Fax

(650) 817-9074

NPI assigned

Jul 2, 2019

Last updated

May 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Telecare Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Carlos, CA
  • NPI 1598833733
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1932761715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37046 WALNUT ST APT C",
            "city": "NEWARK",
            "state": "CA",
            "postal_code": "945602969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1692 EL CAMINO REAL",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940705208",
            "telephone_number": "650-817-9070",
            "fax_number": "650-817-9074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2595 Depot Rd",
            "address_purpose": "LOCATION",
            "city": "Hayward",
            "state": "CA",
            "postal_code": "945452341",
            "country_code": "US",
            "telephone_number": "510-784-5878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKIE",
        "first_name": "ASHLEY",
        "middle_name": "LYNN",
        "credential": "RADT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "14144-RAC",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Luykx, ASW
• Nathalie Lynch, MD
• Kelsey Lyons
• M2 Talent Incorporated
• Yvette Marie Macdonald, LCSW
• Alison Hanna Maffucci
• Naveen Mahmood, MD
• Lisha Mainz, D.C.
• Tara Anita Mann, LCSW
• Brendon Manno, LMFT, LPCC

• Community Health Worker in San Carlos, CA
• Providers in San Carlos, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.